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Dentists 'sickest of all health professionals'

Dentists are the sickest of all health professionals, according to the head of an NHS service aimed at helping clinicians struggling with physical or mental illnesses.

Clare Gerada, medical director of the NHS Practitioner Health Programme (PHP) – the scheme set up a year ago to encourage doctors and dentists with addictions or mental health problems to come forward for treatment – said she believed the project had reached only the ‘tip of the iceberg' of ill dentists.

The free, confidential service for practitioners living or working in the London area was launched by the National Clinical Assessment Service amid concerns that some doctors and dentists were either struggling to access appropriate care or were suffering in silence rather than seeking proper medical help because of fears they would be stigmatised.

A report on the first year of the scheme's operation, published last month, showed that 184 doctors or dentists had been offered an initial assessment, with 62% presenting with mental health problems, 36% addictions and 2% physical health problems. The patients were mainly doctors but also included 15 dentists and two nurses.

After 12 months, 88% of those who had reported an illicit drug addiction were abstinent and 46% who had not been working were back at work – a much higher success rate than comparable schemes for the general population.

Dr Gerada said: ‘Lives had been transformed' in the first year of the programme – but warned that more needed to be done to help dentists in particular.

She added: ‘Dentists on the whole are at the far end of complexity and sickness. They come to us very, very unwell, for example with severe alcohol addiction, or they might have had a fit, or with severe depression.

‘They are a much sicker group [than other health professionals]. They work in a much more isolated manner, sometimes in small teams, and they're the boss. They don't go to doctors and many can't identify their GP. They might also have financial problems, or back problems, which they don't want to disclose.'

Dr Gerada said while she believed the scheme had got through to a significant proportion of doctors with health problems in the M25 area, for dentists those that were presenting were the ‘tip of the iceberg'.

The report found that interest in the scheme among dentists had dropped off over the year. In the first quarter, dentists represented 17% of all initial assessments. This fell to 8% across the whole year.

‘Additional awareness raising among dentists was initiated as a result of this drop in attendance rates', the report said.

Dr Gerada, who has approached the General Dental Council to try to seek more referrals, said she wanted to create ‘a whole network across whole of the country of experienced doctors who can manage sick health professionals'.

Plans are underway to launch similar schemes in Avon and Newcastle, but it is not thought that every area of the country will need one because patients are said to be willing to travel some distance for specialist help.

Liam Donaldson, the chief medical officer, who came up with the idea for the service, said: ‘In any workforce, a small minority will have health problems, but the degree of denial in the medical profession is a problem not only for doctors and dentists but also potentially for patients.'

Sir Liam said the PHP had been a ‘remarkable success' in uncovering problems that would not otherwise have been addressed. Interventions had in many cases been ‘highly effective', he said, adding: ‘This problem was largely buried under the surface before and it was getting worse – with patients potentially being harmed. From the number of patients accessing the programme during its first year of operation, it is clear that there is a need for this highly specialised service.'